Fat Malabsorption Fat and Fat Soluble Nutrients

Patients with pancreatic insufficiency are unable to produce and secrete enough enzymes to aid with the breakdown of fats in the intestinal lumen. Studies of normal adults and those with pancreatic insufficiency have demonstrated that pancreatic enzyme secretion needs to be less than 15% of normal levels before significant steatorrhea is seen (Figure 1). Once clinically significant steatorrhea is determined, recovery of pancreatic function is unlikely.

Historically, patients with pancreatic insufficiency due to cystic fibrosis (CF) were told to minimize symptoms of steatorrhea by limiting dietary fat. However, epidemiologic studies confirmed that this advice led to negative energy balance, undernutrition, and higher mortality rates compared to communities in which CF patients were treated with high-energy, high-fat diets. The introduction of effective pancreatic replacement therapy has been heralded as one of the

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